BROOKHAVEN HOSPITAL (NPI# 1982943445) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982943445 |
| Entity Type | Organization |
| Organization Name | BROOKHAVEN HOSPITAL |
| Practice Address |
201 S Garnett Rd Tulsa OK 74128-1805 |
| Mailing Address |
8014 S Wheeling Ave Apt H Tulsa OK 74136-5224 |
| Practice Telephone | 9184384257 |
| Mailing Telephone | 5802241785 |
| Enumeration Date | 2013-02-04 |
| Last Update Date | 2013-02-04 |
| Authorized Official Name | DR. ROLF B GAINER (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 9184384257 |
| Authorized Official Credential | PH.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oklahoma Business Registrations | BROOKHAVEN HOSPITAL PROPERTY, LLC | 201 S Garnett, Tulsa, OK 74128 |
| Street Address |
201 S GARNETT RD |
| City | TULSA |
| State | OK |
| Zip Code | 74128-1805 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023064300 | Brookhaven Hospital Inc. | Rehabilitation Unit | 201 S Garnett Rd, Tulsa, OK 74128 | 2006-05-26 |
| 1710455282 | Jordan Hearod | Case Manager/Care Coordinator | 201 S Garnett Rd, Tulsa, OK 74128-1800 | 2018-11-02 |
| 1851868798 | Victoria Maderazo | Nurse Practitioner | 201 S Garnett Rd, Tulsa, OK 74128-1805 | 2018-10-29 |
| 1316349269 | Kami Robinson | Counselor | 201 S Garnett Rd, Tulsa, OK 74128-1805 | 2014-09-23 |
| 1831533421 | Charles D. Van Tuyl, Ph.d., M.d. | Psychiatry & Neurology | 201 S Garnett Rd, Tulsa, OK 74128-1805 | 2013-04-25 |
| 1073854238 | Cyndee Suzanne Johnson | Case Manager/Care Coordinator | 201 S Garnett Rd, Tulsa, OK 74128-1805 | 2013-03-12 |
| 1396080347 | Karen S Lacy | Counselor | 201 S Garnett Rd, Tulsa, OK 74128-1805 | 2012-12-03 |
| 1801146428 | Erika Beth Link-siemens | Counselor | 201 S Garnett Rd, Tulsa, OK 74128-1805 | 2012-09-11 |
| 1417234709 | Sarah J Williams | Counselor | 201 S Garnett Rd, Tulsa, OK 74128-1805 | 2011-11-15 |
| 1427333624 | M.j. Clausen | Counselor | 201 S Garnett Rd, Tulsa, OK 74128-1805 | 2011-10-19 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639720352 | Nicole Piggee | Technician | 10548 East 5th Street, Tulsa, OK 74128 | 2019-09-24 |
| 1598252884 | Beth Alison Peck | Social Worker | 10159 East 11th Street, Tulsa, OK 74128 | 2018-04-23 |
| 1821434523 | Ta'vionna Danielle Polley-davis (whayne) | Counselor | 1148 E. 20th St, Unit A, Tulsa, OK 74128 | 2013-05-21 |
| 1881753572 | Mashovin Home Health Care, Inc. | Home Health | 12131 East Skelly Drive, Tulsa, OK 74128 | 2006-12-08 |
| 1841689189 | David L Hinman | Counselor | 2001 S Garnett Rd, Suite G, Tulsa, OK 74128 | 2015-01-09 |
| 1992019582 | Ryan John Wilson | Counselor | 2725 E. Skelly Dr., Suite 202, Tulsa, OK 74128 | 2010-08-06 |
| 1376786590 | Dana Furtado | Social Worker | Department of Veterans Affairs, 10159 E. 11th Street, Suite #100, Tulsa, OK 74128 | 2009-04-17 |
| 1033391370 | Genevieve Dulan | Family Medicine | 10912 E 14th St, Tulsa, OK 74128 | 2007-11-28 |
| 1215098017 | Paul Chesley Cochran | Psychiatry & Neurology | 141 S Garnett Rd, Tulsa, OK 74128 | 2006-12-13 |
| 1548700826 | Kristina Marcotte | Case Management | 9756 E 4th Pl, Tulsa, OK 74128-1247 | 2017-03-06 |
| Find all providers in zip 74128 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114321486 | Cedric Glenn | Community Based Residential Treatment Facility, Mental Illness | 1721 E 72nd St, 1803, Tulsa, OK 74136-5372 | 2014-10-15 |
| 1790922185 | State of Oklahoma | Community Based Residential Treatment Facility, Mental Illness | 2323 South Harvard, Tulsa, OK 74114 | 2009-01-07 |
| 1417024761 | Volunteers of America Inc. | Community Based Residential Treatment Facility, Mental Illness | 2715 E 15th St, Tulsa, OK 74104-4713 | 2006-11-30 |
| 1881760213 | Volunteers of America Inc. | Community Based Residential Treatment Facility, Mental Illness | 3931 S Oswego Ave, Tulsa, OK 74135-2428 | 2006-11-28 |
| 1457356560 | Tulsa County Juvenile Justice Trust Authority | Community Based Residential Treatment Facility, Mental Illness | 4012 E 35th St, Tulsa, OK 74135-4528 | 2005-06-15 |
| 1922440171 | Tulsa Center for Behaviour Health | Community Based Residential Treatment Facility, Mental Illness | 2323 S Harvard Ave, Tulsa, OK 74114-3301 | 2013-07-29 |
| 1225030695 | Volunteers of America Inc., Crewson Youth Centers | Community Based Residential Treatment Facility, Mental Illness | 4012 E 35th St, Tulsa, OK 74135-4528 | 2005-08-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801321070 | April Brock | Community Based Residential Treatment Facility, Mental Illness | 106 12th Ave Ne, Miami, OK 74354-3373 | 2017-04-25 |
| 1083058523 | Mongo Allen | Community Based Residential Treatment Facility, Mental Illness | 829 Nw 142nd St, Edmond, OK 73013-1962 | 2013-04-27 |
| 1801133236 | Southeastern Oklahoma Family Services | Community Based Residential Treatment Facility, Mental Illness | 1501 N Washington Ave, Durant, OK 74701-2127 | 2013-01-04 |
| 1043595879 | Oaktree Counseling Services | Community Based Residential Treatment Facility, Mental Illness | 2104 Nw Britni Cir, Lawton, OK 73505-3121 | 2011-10-12 |
| 1790089829 | Southern Oklahoma Treatment Services | Community Based Residential Treatment Facility, Mental Illness | 5862 Us Hwy 70, Mead, OK 73449 | 2011-01-04 |
| 1285966747 | Dr. C Professional Services, Pllc | Community Based Residential Treatment Facility, Mental Illness | 7109 S Kentucky Ave, Oklahoma City, OK 73159-3427 | 2010-02-09 |
| 1881921898 | Sequoyah Residential Mental Health Facility, Inc | Community Based Residential Treatment Facility, Mental Illness | 103 N Wheeler Ave, Sallisaw, OK 74955-4617 | 2009-11-11 |
| 1558570309 | Meadow Brook Residential Care Facility | Community Based Residential Treatment Facility, Mental Illness | 1000 Meadow Lane, Howe, OK 74940 | 2007-05-21 |
| 1568580108 | Transition House, Inc. | Community Based Residential Treatment Facility, Mental Illness | 700 Asp Ave, Suite 2, Norman, OK 73069-4900 | 2007-03-26 |
| 1679665079 | Williams Counseling LLC | Community Based Residential Treatment Facility, Mental Illness | 824 Annie Court, Norman, OK 73069-4236 | 2006-09-29 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.